Auchlochan Care Home Service Adults New Trows Road Lesmahagow Lanark ML11 0JS Telephone: 01555 893706
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Auchlochan Care Home Service Adults New Trows Road Lesmahagow Lanark ML11 0JS Telephone: 01555 893706 Inspected by: Joy Fleming Marie Paterson Fiona Stevenson Rose Bradley Type of inspection: Unannounced Inspection completed on: 23 October 2013 Inspection report continued Contents Page No Summary 3 1 About the service we inspected 5 2 How we inspected this service 7 3 The inspection 13 4 Other information 39 5 Summary of grades 40 6 Inspection and grading history 40 Service provided by: MHA Auchlochan Service provider number: SP2008010194 Care service number: CS2008192850 Contact details for the inspector who inspected this service: Joy Fleming Telephone 0141 843 6840 Email [email protected] Auchlochan, page 2 of 42 Inspection report continued Summary This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change after this inspection following other regulatory activity. For example, if we have to take enforcement action to make the service improve, or if we investigate and agree with a complaint someone makes about the service. We gave the service these grades Quality of Care and Support 2 Weak Quality of Environment 2 Weak Quality of Staffing 2 Weak Quality of Management and Leadership 2 Weak What the service does well We received some positive feedback from residents and relatives. We saw some positive interactions between staff, residents and relatives which showed us that good relationships had been developed. What the service could do better We identified a number of areas of development in relation to staffing, staff practice and the environment. What the service has done since the last inspection We found that some staff had continued to work hard and provide a good service. Conclusion We received a range of feedback from residents and relatives. Whilst we could see that there was a lot of good work being carried out, we were concerned at gaps and inconsistencies in relation to overall management and some staffing practices. Auchlochan, page 3 of 42 Inspection report continued We found that the environment also needed considerable work. As a result, we have made a number of requirements and this has impacted on the grades. Who did this inspection Joy Fleming Marie Paterson Fiona Stevenson Rose Bradley Lay assessor: Mrs Catherine McEvoy Auchlochan, page 4 of 42 Inspection report continued 1 About the service we inspected The service known as Auchlochan is provided and run by Methodist Homes Association (MHA) which has its headquarters in Derby. It is provided within two separate neighbouring care home buildings. Nethanvale has 3 floors providing accommodation for 68 people. There are two dementia units for 32 people. Lower Johnshill has 3 floors with accommodation on each floor. It provides residential care for 79 people. There is a dementia unit for 17 people. A respite service is provided in both units. At the time of this inspection, the provider had submitted a variation to the CI to have each building registered as a separate service. The location of the service is within a very well maintained and attractive Auchlochan Garden Village. The site also contains a range of facilities such as, privately owned retirement homes, a housing support service, a restaurant, shop and café. It is situated in a rural area outwith the Lanarkshire town of Lesmahagow. MHA's Mission Statement is: 'To improve the quality of life for older people, inspired by Christian concern - this is based on the provision of high quality person centred care and support, founded on respect for individuality, personal choice and dignity and focused on nurturing a persons spiritual and physical wellbeing.' Auchlochan, page 5 of 42 Inspection report continued Based on the findings of this inspection this service has been awarded the following grades: Quality of Care and Support - Grade 2 - Weak Quality of Environment - Grade 2 - Weak Quality of Staffing - Grade 2 - Weak Quality of Management and Leadership - Grade 2 - Weak This report and grades represent our assessment of the quality of the areas of performance which were examined during this inspection. Grades for this care service may change following other regulatory activity. You can find the most up-to-date grades for this service by visiting our website www.careinspectorate.com or by calling us on 0845 600 9527 or visiting one of our offices. Auchlochan, page 6 of 42 Inspection report continued 2 How we inspected this service The level of inspection we carried out In this service we carried out a high intensity inspection. We carry out these inspections where we have assessed the service may need a more intense inspection. What we did during the inspection An unannounced inspection visit was carried out by Joy Fleming, Inspector and Marie Paterson, Team Manager on Tuesday 1 October 2013 between 4.30pm and 10.30pm. A further visit was carried out the following day by Joy Fleming, Marie Paterson, Fiona Stevenson, Inspector, Rose Bradley, Inspector and Catherine McEvoy, Lay Assessor between 10am and 8.30pm. A discussion about the findings of the inspection was held in the Care Inspectorate (CI) office on Friday 11 October 2013. This was attended by Joy Fleming and Marie Paterson and Bob McLean, Managing Director, Lesley McNeill, Care & Support Services Manager, Duncan Dewar, acting Care Home Manager, Margo Bruton, Head of Care, all from Methodist Homes Association (MHA). During that meeting we were told about further work which was planned, some of which was underway. We agreed to look at further information and this was sent in via email. We received 35 Care Standard Questionnaires from residents and relatives. During the inspection visits, we talked with several residents and relatives individually as we walked around the care home. We also had a look at the environment and observed staff practice and residents' experiences. We talked with some nursing, care, activity and kitchen staff who were on shift. We also looked at a wide range of records relating to service provision and residents' care and support some policies, personal plans, accident and incident reports, minutes of residents' and staff meetings, audits and training records. We took all of the above into account when we wrote this report. Auchlochan, page 7 of 42 Inspection report continued Grading the service against quality themes and statements We inspect and grade elements of care that we call 'quality themes'. For example, one of the quality themes we might look at is 'Quality of care and support'. Under each quality theme are 'quality statements' which describe what a service should be doing well for that theme. We grade how the service performs against the quality themes and statements. Details of what we found are in Section 3: The inspection Inspection Focus Areas (IFAs) In any year we may decide on specific aspects of care to focus on during our inspections. These are extra checks we make on top of all the normal ones we make during inspection. We do this to gather information about the quality of these aspects of care on a national basis. Where we have examined an inspection focus area we will clearly identify it under the relevant quality statement. Fire safety issues We do not regulate fire safety. Local fire and rescue services are responsible for checking services. However, where significant fire safety issues become apparent, we will alert the relevant fire and rescue services so they may consider what action to take. You can find out more about care services' responsibilities for fire safety at www.firelawscotland.org Auchlochan, page 8 of 42 Inspection report continued What the service has done to meet any requirements we made at our last inspection The requirement 1. The provider must ensure that service user's (residents) personal plans (care plans) are sufficiently detailed, evaluated and kept up date. This must include: - Clear care plan recording which states and differentiates between the reasons why a resident requires support and how the support will be provided. - Clear and detailed recording of residents' current health and wellbeing needs to ensure that staff fully understand how both physical and psychological needs of residents affect their daily lives and how best to manage these. This must include detailing any unique and individual behaviours exhibited by residents. - Clear recording of any changes in care needs, which ensure that the care provided is updated to reflect current care and previous care. As part of this consideration must also be given to when to archive past information about old care interventions. - The timing of care plan summaries is carried out consistently across the nursing team and that the managers audit care plan files at periodic intervals to monitor content and consistency of recording. This is in order to comply with The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011/210, Regulation 4 (1) (a) Welfare of users- a requirement that a provider must make proper provision for the health and welfare of service users and Regulation 5 (b) (ii) Personal Plans- review the personal plan when there is a significant change in a service user's health, welfare or safety needs. Timescale for implementation: Within 8 weeks of the publication date of this report. What the service did to meet the requirement For the purposes of this report, we have marked this as met. We found significant gaps in a range of areas to do with care planning and have made new specific requirements in this report as a result. Please see Quality Statement 1.3. The requirement is: Met - Within Timescales Auchlochan, page 9 of 42 Inspection report continued The requirement 2. The provider must ensure that personal planning about wound management is thoroughly completed to detail the actual care that has been given to the resident.